4.3.3 Interventional Treatment for Liver Cancer

4.3.3 Interventional Treatment for Liver Cancer

Given the high incidence of liver cancer and the fact that most patients are diagnosed at advanced stages, with few eligible for surgery, non-surgical therapies are predominantly used. Normally, 80% of the liver's blood supply comes from the portal vein, while 90%–100% of liver cancer's blood supply comes from the hepatic artery. Due to this unique blood supply pattern of the liver, since the beginning of this century, domestic and international scholars have researched transcatheter hepatic arterial embolization, transcatheter hepatic arterial chemoembolization, and ultrasound-guided percutaneous ethanol injection, all aimed at blocking the blood supply to liver cancer. These therapies are the first choice for patients whose tumors cannot be surgically removed, offering simple procedures, minimal trauma, and direct drug delivery to the affected area. Common embolic agents include gelatin sponge, iodized oil, and traditional Chinese medicine embolizing agents. Chemotherapy drugs such as doxorubicin and mitomycin C are effective against all phases of cell division and the G0 phase, while cisplatin and fluorouracil specifically target certain phases of cell proliferation. Currently, embolic agents are often combined with chemotherapy drugs and injected into the hepatic artery, which not only increases the drug concentration in the tumor tissue but also slows down blood flow, prolonging the contact time between cancer cells and drugs. Under conditions of ischemia, cancer cells are more easily penetrated by drugs, leading to cell death, thus achieving the therapeutic goal of shrinking the tumor and thoroughly eliminating any residual cancer cells after surgery [88]. Ultrasound-guided percutaneous ethanol injection has also evolved into CT-guided procedures.